MINISTRY OF FOREIGN AFFAIRS

PROTOCOL DIVISION
THIMPHU
VISA APPLICATION FORM
(Please fill in block capital letters)

Note: If any particulars furnished below are found to be incorrect or if any information is found to have been withheld,
The visa if granted, is liable to be cancelled at any time.

1. Full Name: Mr./Mrs./Ms

Permanent Address:

3. Place of Birth: Date of Birth:

4. Nationality:

5. Nature of Passport: O Diplomatic o Official o ORDINARY o UN Laissez Passer

6. Passport Number: Date of Issue:

` Place of Issue: Date of Expiry:

7. Occupation / Profession:

8. Period for which visa is required: From 17-Sept-2018 To 24-Sept-2018

9. Point of entry / exit in Bhutan: Entry Point: Paro

Exit Point: Paro

10. Purpose for visiting Bhutan: Pilgrimage

11. Is this your first visit to Bhutan? Yes / No. If not, give details of earlier visit:

Place
Date

Signature of applicant

(*Please delete whichever is not applicable)

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For official use only: (Attach passport size photograph)
Type of visa
Visa Number
Date of issue
Visa Clearance Number